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Personality disorder and psychiatric illness in general practice.
The British Journal of Psychiatry : the Journal of Mental Science
|February 1, 1990
Summary
This study reveals that personality disorder is significantly underdiagnosed in general practice. Structured interviews uncover a much higher prevalence (28%) than routine assessments, highlighting a hidden mental health burden.
Area of Science:
- Psychiatry
- General Practice
- Epidemiology
Background:
- Personality disorder is a significant psychiatric morbidity.
- Current diagnostic rates in general practice may underestimate its prevalence.
- Understanding the true prevalence is crucial for effective patient care.
Purpose of the Study:
- To determine the one-year prevalence of personality disorder in urban and rural general practices.
- To compare diagnoses made by general practitioners (GPs) and psychiatrists versus structured interviews.
- To explore associations between personality disorder and other mental state disorders.
Main Methods:
- A one-year prevalence study conducted in two group general practices (urban and rural).
- Psychiatric morbidity, including personality disorder, was assessed.
- Diagnoses were compared between GP/psychiatrist assessments and a structured interview schedule.
Main Results:
- Personality disorder was diagnosed in 5.3% by GPs and 5.6% by psychiatrists.
- Structured interviews revealed a significantly higher prevalence of 28%.
- Higher prevalence was noted in urban versus rural practices, with a notable association with alcohol abuse and dependence.
Conclusions:
- A substantial proportion of personality disorder remains undiagnosed in primary care settings.
- Structured interviews are essential for accurately identifying this 'hidden morbidity'.
- Improved recognition of personality disorder is vital for both general and psychiatric practice.